Over the last 80 years, the percentage of Americans over the age of 65 has steadily increased. This is due primarily to improvements in the quality and availability of health care, resulting in an increase in the average life span of Americans. With the aging of the “baby boomer” generation, there will be an expected exponential increase in the number of elderly Americans over the next 40 years. The US Census Department predicts the number of elderly Americans to rise from 35 million in 2000 (12% of total population) to 86.7 million in 2050 (20.7% of total population).
With the swelling of the elderly population, comes a concomitant increase in the prevalence of age-related disabilities and diseases. Fifty-four percent (54%) of Americans report at least one disability and 37% report more than one disability. The number of Americans reporting disabilities increases each decade of life after the 5th decade. Almost all elderly Americans report having been diagnosed with one of the following conditions: hypertension, arthritis, heart disease, cancer, diabetes, or sinusitis. Most of these subjects are reported having more than one of the above conditions.
This is of great importance due to the rising cost of health care and reduced income associated with aging. It has been reported that 33% of Americans over the age of 65 derive 90% of their total income from Social Security. All but 1% of elderly Americans have some form of health insurance, but in 2003 they paid on average of 12.5% of their total income to cover health care expenses. Increased disease and disability rates result in decreased functional capacity, decreased independence, and consequently the need to hire home health care or to move into nursing homes. In 1999, 10.5 out of every 1000 Americans between the ages of 65-74 lived in nursing homes. The number of nursing home residents increases relative to age for elderly Americans between the ages of 75-84 yrs. (41 out of 1000) and 85-94 yrs. (163.5 out of 1000). Living in a nursing home or hiring home healthcare are both associated with a decreased level of physical activity.
Aside from disease and disability, normal aging results in decreases in strength, balance control, gait velocity, and changes in gait mechanics. These decreases have a profound impact on elders' ability to ambulate which in turn dictates their functional capabilities and ultimately, their level of independence. Assistive technologies such as walkers are often employed to prevent pathologies and impairments from causing functional limitations. The common walker is designed such that users support themselves by interfacing with the walker through their hands and wrists. Walkers are intended to provide bilateral balance support and mild to moderate off-loading of an individual's body weight. Thus, users should push a walker along as they maintain a relatively normal walking speed; however, most either walk at a reduced velocity or actually lift and set down the walker with every step. The effects are altered gait mechanics and decreased gait velocity which is independently associated with increased deficits in instrumental activities of daily living (IADL) and activities of daily living (ADL).
Along with aging, other permanently or temporarily disabled individuals rely on walking aids for ambulation. For example, patients with a traumatic brain injury may need walking assistance for life to avoid further injury resulting from falls. Patients with lower extremity orthopedic injuries (e.g. knee or ankle ligament sprain, muscle strain, etc.) may temporarily need the assistance of a walking aid. These populations often rely on the same technology used by the elderly that alters walking speed and may result in increased disability or increased rehabilitation time.
Another problem with traditional walkers is that users often use the device more like a crutch than an aid; they literally rely too heavily on the walker by off-loading a large percentage of their body weight which increases stress and strain through the upper extremities, while simultaneously reducing ground reaction forces that are necessary to maintain lower extremity and trunk musculoskeletal integrity.
Additionally, users often adopt poor posture when using a traditional walker, i.e., greater neck, trunk, and hip flexion as well as increased scapular protraction. Thus, instead of helping the elderly, traditional walkers might actually facilitate functional limitations and disability by decreasing gait velocity, strength, balance control and contributing to poor posture and walking mechanics. Ultimately, these assistive devices then contribute to decreased activity which leads to increased disability.
Current walkers provide: 1) a wheeled device with support provided beneath the user's arms that promotes an upright posture as disclosed and illustrated in FIG. 1 of U.S. Pat. No. 2,792,052; 2) a wheeled device with support provided through either the user's elbows and forearms or the user's hands as disclosed and illustrated in FIG. 2 of U.S. Pat. No. 4,510,956; 3) a wheeled device fully encircling the user and employing handgrip support, optional seating, and a belted restraint system as disclosed and illustrated in FIG. 3 of U.S. Pat. No. 4,770,410; 4) a three wheeled device with support provided via a handrail and in which all structures are in front of the user; i.e., there are no side panels as disclosed and illustrated in FIG. 4 of U.S. Pat. No. 4,765,355; and 5) a fixed wheel device with support provided through the user's hands and employing foldable storage capability as disclosed and illustrated in FIG. 5 of U.S. Pat. No. 4,461,471.
U.S. Pat. No. 7,294,094 discloses a walker design supporting the user by connecting a harness from the user to the walker high on the back. U.S. Pat. No. 7,275,554 discloses a walker design supporting the user near the underarms. U.S. Pat. No. 6,733,018 discloses a walker design supporting the user under the arm by a harness in which the user sits.
Although many and varied solutions to the walker problem have been disclosed, they all have advantages and disadvantages. Thus, there is a continued need in the art for a walker apparatus that alleviates some of the problems with walkers of the prior art, while improving the mobility of patients with temporarily impaired mobility.